 |
|
Nicotinamide and Tetracycline Therapy of Bullous Pemphigoid
David P. Fivenson, MD;
Debra L. Breneman, MD;
Gary B. Rosen, MD;
Craig S. Hersh, MD;
Scott Cardone, MD;
Diya Mutasim, MD
Arch Dermatol. 1994;130(6):753-758.
Abstract
| |
Background and Design
The combination of nicotinamide and tetracycline has been anecdotally reported to be effective in the treatment of bullous pemphigoid. We conducted a randomized, open-labeled trial comparing the combination of 500 mg of nicotinamide, three times daily, and 500 mg of tetracycline four times daily, with prednisone therapy in 20 patients with bullous pemphigoid. The study was divided between an 8-week acute phase with fixed drug dosages and a 10-month follow-up phase in which study medications were tapered based on patient response.
Results
Eighteen of 20 patients enrolled in the study were treated, two patients were unavailable for follow-up. Twelve patients were treated with the combination of nicotinamide and tetracycline and six patients were treated with prednisone. There were five complete responses, five partial responses, one nonresponder, and one patient with disease progression in the nicotinamide and tetracycline group compared with one complete response and five partial responses in the predni- sone group. There were no statistically significant differences in response parameters between the two groups. All five patients in the nicotinamide and tetracycline group receiving long-term follow-up remained disease free during medication tapering, while three patients in the prednisone group had repeated disease flareups with steroid tapering. Adverse effects in the nicotinamide and tetracycline group included gastrointestinal upset (two patients) and transient renal failure (one patient). In the prednisone group, there was one occurrence each of hypertension, erosive gastritis, multiple decubitus ulcers, osteomyelitis, deep venous thrombosis, and death related to sepsis. Two patients required insulin therapy for hyperglycemia.
Conclusions
The combination of nicotinamide and tetracycline appears to be a useful alternative to systemic steroids in the treatment of bullous pemphigoid.
(Arch Dermatol. 1994;130:753-758)
Author Affiliations
From the Department of Dermatology, Henry Ford Hospital, Detroit, Mich (Drs Fivenson, Rosen, and Hersh), and the Department of Dermatology, University of Cincinnati (Ohio) (Drs Breneman, Cardone, and Mutasim).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
A Comparison of Oral Methylprednisolone Plus Azathioprine or Mycophenolate Mofetil for the Treatment of Bullous Pemphigoid
Beissert et al.
Arch Dermatol 2007;143:1536-1542.
ABSTRACT
| FULL TEXT
A Retrospective Study Regarding the Treatment of Lupoid Onychodystrophy in 30 Dogs and Literature Review
Mueller et al.
Journal of the American Animal Hospital Association 2003;39:139-150.
ABSTRACT
| FULL TEXT
Oral and Topical Corticosteroids in Bullous Pemphigoid
Korman et al.
NEJM 2002;347:143-145.
FULL TEXT
Risk Factors for Lethal Outcome in Patients With Bullous Pemphigoid: Low Serum Albumin Level, High Dosage of Glucocorticosteroids, and Old Age
Rzany et al.
Arch Dermatol 2002;138:903-908.
ABSTRACT
| FULL TEXT
A Systematic Review of Treatments for Bullous Pemphigoid
Khumalo et al.
Arch Dermatol 2002;138:385-389.
ABSTRACT
| FULL TEXT
Minocycline-Induced Hyperpigmentation in Patients With Pemphigus and Pemphigoid
Ozog et al.
Arch Dermatol 2000;136:1133-1138.
ABSTRACT
| FULL TEXT
Management of Acquired Bullous Skin Diseases
Fine
NEJM 1995;333:1475-1484.
FULL TEXT
Nicotinamide and Tetracycline Effective for Bullous Pemphigoid
Journal Watch Dermatology 1994;1994:1-1.
FULL TEXT
Dermatology and the Evolution of Therapies to Control Inflammatory Tissue Injury
Lorincz
Arch Dermatol 1994;130:781-782.
ABSTRACT
|
